1086 Williams Road Lot 4Davie County, NC
Tax Parcel Report
Wednesday. November 9.2016
All data is provided as is wtihoutis ramy arguannfee of my kind ehhere>pressed or Implied including but not limited to the
Davie County, ImpliedwarnntiesamechantabilhyarflhmssMapargwWruse.AllsameofDaMCCounty'sGISwebakeandlholdhamliessthe
County of Davie, Nodh Carolina, its agents, eonsultama, contractors oremployea from any end all dalms oeauses a action due to
NC or addng"of the use "Inability b use the GIS data provided by this rmbdte,
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number:
17 00 00 00431 1
`,
1103
NCPIN Number:
;t
Municipality:
Account Number:
�\\-
Census Tract:
37059-804
Listed Owner 1:
� 1142
'1128
Voting Precinct
FULTON
Mailing Address 1:
112
Planning Jurisdiction:
Davie County
City: ADVANCE
1122
1067
NC
Zoning Overlay:
Zip Code:
27006-7132
Voluntary Ag. District:
i
(10
LOT 4 CARTERS COURT
1110
FORK
L,P�1S
1.96
Elementary School Zone:
--i
'
Deed Date:
1
Middle School Zone:
1126
it
i 1072 ',1086
003860962
Soil Types:
WeC,WeB,PcB2
Plat Book:
0007
Flood Zone:
r
086
Watershed Overlay:
DAVIE COUNTY
Ir
z
Outbuilding B Extra
Freatures Value:
0.00
1064.JI
d
Total Market Value:
87580.00
Total Assessed Value:
87580.00
149
All data is provided as is wtihoutis ramy arguannfee of my kind ehhere>pressed or Implied including but not limited to the
Davie County, ImpliedwarnntiesamechantabilhyarflhmssMapargwWruse.AllsameofDaMCCounty'sGISwebakeandlholdhamliessthe
County of Davie, Nodh Carolina, its agents, eonsultama, contractors oremployea from any end all dalms oeauses a action due to
NC or addng"of the use "Inability b use the GIS data provided by this rmbdte,
WARNING: THIS IS NOT A SURVEY
Parcel Information
Parcel Number:
17 00 00 00431 1
Township,
Fulton
NCPIN Number:
5778069661
Municipality:
Account Number:
82517542
Census Tract:
37059-804
Listed Owner 1:
GAMBLE DONNA H
Voting Precinct
FULTON
Mailing Address 1:
1086 WILLIAMS ROAD
Planning Jurisdiction:
Davie County
City: ADVANCE
Zoning Class: DAVIE COUNTY R -A
State:
NC
Zoning Overlay:
Zip Code:
27006-7132
Voluntary Ag. District:
No
Legal Description:
LOT 4 CARTERS COURT
Fire Response District:
FORK
Assessed Acreage:
1.96
Elementary School Zone:
CORNATZER
Deed Date:
9/2001
Middle School Zone:
WILLIAM ELLIS
Deed Book/Page:
003860962
Soil Types:
WeC,WeB,PcB2
Plat Book:
0007
Flood Zone:
Plat Page:
086
Watershed Overlay:
DAVIE COUNTY
Building Value:
57700.00
Outbuilding B Extra
Freatures Value:
0.00
Land Value:
29880.00
Total Market Value:
87580.00
Total Assessed Value:
87580.00
All data is provided as is wtihoutis ramy arguannfee of my kind ehhere>pressed or Implied including but not limited to the
Davie County, ImpliedwarnntiesamechantabilhyarflhmssMapargwWruse.AllsameofDaMCCounty'sGISwebakeandlholdhamliessthe
County of Davie, Nodh Carolina, its agents, eonsultama, contractors oremployea from any end all dalms oeauses a action due to
NC or addng"of the use "Inability b use the GIS data provided by this rmbdte,
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
IMPROVEMENT/OPERATION PERMIT
Account #: 990001865 Tax PIN/EH #: 5778-06-7187.dg
Billed To: Donna Gamble Subdivision Info: Carters Court Sec 1 Lot # 4
Reference Name: Location/Address: Williams Road -27006
Proposed Facility: Residence Property Size: see map
ATC Number: 2939
**NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of a septic tank system or any wastewater
system. An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this
Department prior to the construction/installation of a system or the issuance of a building permit (in compliance with
Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS
PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR
WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM.
Residential Specification: Building Type _ #People � #Bedrooms 41 #Baths 2
Dishwasher: X14" Garbage Disposal: ❑ Washing Machine Basement w/Plumbing: ❑ Basement/No Plumbing: ❑
Commercial Specification: Facility Type #People #People/Shift #Seats Industrial Waste: ❑
Lot Size Type Water Supply //-IV Design Wastewater Flow (GPD) Site: NewZ00"Repair ❑
System Specifications: Tank Size/OD P GAL. Pump Tank _GAL. Trench Width IfZRock Depth If Linear Ft i/W
Other:
Required Site Modifications/Conditions:
IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER RISER(S) IF 6 u BELOW
FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this
system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.****
Environmental Health Specialist's Signature:
DCHD 05/99 (Revised)
DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
P. O. Boa 848/210 Hospital Street
Mocksville, NC 27028
(336)751-8760
Account #: 990001865 Tax PIN/EH #: 5778-06-7187.dg
Billed To: Donna Gamble Subdivision Info: Carters Court Sec 1 Lot # 4
Reference Name: Location/Address: Williams Road -27006
Proposed Facility: Residence Property Size: see map
ATC Number: 2939
AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION
**NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental
Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to
the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of
G.S. Chapter 130A, Wastewater Systems, S ion .1900 Sewage Treatment and Disposal Systems). THIS
AUTHORIZATION FOR WASTEWA C N TRUC ION IS ALID AFORIOD OF FIVE YYEARS.
Environmental Health Specialist's Signature: — R — ate:
CERTIFICATE OF COMPLETION
**NOTE** The issuance of this Certificate of Completion shall indicate the system described on Improvement/Operation Permit
has been installed in compliance with Article 11 of G.S. Chapter 130A, Section .1900 "Sewage Treatment and
Disposal Systems," but shall in NO WAY be taken as a guarantee that the system will function satisfactorily for any
given period of time.
l�
AW X—1 i'��c�
Septic System Installed By:
Environmental Health Specialist's Signature: X rC!// Date: % .�G-7
DCHD 05/99 (Revised)
r
6ENVIRONMENTAL
AAPPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATAL 9 1Davie County Health Department
Environmental HealthSection HEALTH
P.O. Box 848/210 Hospital Street DAVIE COUNTY
Mocksville, NC 27028
(336)751-8760
***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to_ the INFORMATION BULLETIN for instructions.
1. Name to be Billed 53"0A Q - M11'C' Contact Person DaGf�tlh�i� 6,411 J` -
Nailing Address SSICLS &I sVHome Phone n -/l -iJ- "7S%f/
city/State/ZIP )aEy p m e �6 D(e Business Phone 11L � 0 3s`I
f
2. Name on Permit/ATC if Different than Above
Mailing Address City/State/Zip
3. Application For: to Evaluation - ❑ Improvement Permit/ATC ❑ Both
4. System to service: ;'House ❑ Mobile Home ❑ Business ❑ Industry ❑ Other
S. If Residence: # People # Bedrooms �l _ # Bathrooms oL
VDishwasher ❑ Garbage Disposal IG) Washing Machine ❑ Basement/Plumbing f] Basement/No Plumbing
6. if Business/Industry/Other: Specify type # People # Sinks
# Commodes # Showers # Urinals # Water Coolers
IF FOODSERVICE: # Seats Estimated Water Usage (gallons per day)
7. Type of water supply: AD/ County/City ❑ Well ❑ Community
a. Do you anticipate additions or expansions of the facility this system is intended to serve? ❑ Yes u1 Ivo
If yes, what type?
***IMPORTANT*** CLIENTS MUSTCOMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BESUBMITTED by the client with THIS APPLICATION.
Property Dimensions: 560- mck P_
Tax Office PIN: # t5- 7 -7 T-8 14--11" da
Property Address: Road Name 0;1(Arn-s Qd
City/Zip ALA (x. QD64
If in a Subdivisionprovideinformation, as follows:
/c—
Name: �Y ��D^' S r
Section: _� Block: Lot:q
WRITE DIRECTIONS (from Mocksville) to PROPERTY:
F><w�l iSFf 6nl 94L4k m,)ice
e�-�-
i
Date Property Flagged: O
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s)
issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if the information
submitted in this application is falsified or changed. I, also, understand that lam responsible for all charges incurred from
this application. I, hereby, give consent to the Authorized Representative of the Davie County Health Department
to enter upon above described property located in Davie County and owned by
to conduct all testing procedures as necessary to determine the site suitability.
DATE
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Include all of the following: Existing and proposed
property lines and dimensions, structures, setbacks, and septic locations).
Revised DCHD (07/99)
Date(s):
EHS:
Site Revisit Charge
Account No.� /
Invoice No. ���
9
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U-11 Wj
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06/26/01 14:57 N :02 N0:039
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
Soil/Site Evaluation
APPLICANT INFORMATION
RMATION PROPERTY INFORMATION
Account #: 990001865 Tax PIN/EH #: 5778-06-7187.dg
Billed To: Donna Gamble Subdivision Info
Reference Name: - Location/Address Williams R6ad-27006
Proposed Facility: Residence Property Size. see map Date Evahiatedc
Pro ert ,
Water Supply: On -Site Well Communis Public
Y
Evaluation By: r Auger Boring Pit Cut
LONG-TERM ACCEPTANCE RATE
: SITE CLASSIFICATION: EVALUATI,ON BY:
LONG-TERM ACCEPTANCE RATE: OTHER(S) PRESENT:
REMARKS:
LEGEND
Landscape Position'
RL- Ridge . S - Shoulder L - Linear slope FS - Foot slope N - Nose slope
- CC -Concave slope L CV - Convex slope T - Terrace FP - Flood plain H - Head slope
Texture _.
S - Sand LS Loam sand SL.,
y Sandy loam', L -Loam SI -Silt
SICL - Silty clay loam SIL - Silty loam . CL - Clay loam SCL - Sandy clay loam
SC - Sandy clay SIC - Silty clay. C.- Clay
CONSISTENCE
-Moist
VFR - Very friable FR - Friable , FI Firm VFI - Very firm EFI Extremely fine
Wet
NS - Non sticky SS - Slightly sticky S - Sticky VS - Very Sticky
NP - Non plastic SP - Slightly plastic. P - Plastic VP - Very plastic .
Structure
SC - Single grain M - Massive CR - Crumb GR - Granular ' ABK - Angular blocky
SBK - Subangular blocky PL Platy PR - Prismatic
Mineraloev
1:1, 2:1, Mixed
Notes
Horizon depth - In inches
Depth of fill - In inches
Restrictive horizon - Thickness and inches from land surface
Saprolite - S(suitable), U(unsuitable)
Soil wetness - Inches from land surface to free water or inches from land surface to soil colors with chroma 2 or less
Classification- S(suitable), PS(provisionally suitable), U(unsuitable)
LTAR - Long-term acceptance rate - gal/day/ft2
DCHD 05/99 (Revised)
APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC
Davie County Health Department
Environmental Healfh SecYfon
P.O. Box 848/210 Hospital Street
Mockeville, NC 27028
(336)751-8760
I JUN 2 3 1999
IF FOODSERVICE: # Seats Estimated Stater Usage (gallons per day)
7. Type of water supply: 0 County/City 0 Well 0 Community
a. foo you anticipate additions or expansions of the facWty this system is intended to serve? 0 Yes D No
If yes, what type?
***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BE SVBA977FO by the client with THIS APPLICATION.
7Ar svor,Z o
Property Dimensions: G� WRITE DIRECTIONS (from Mocleville) to PROPERTY:
Tax Office PIN: # 5? 7 5�- 0 6 7, o y�/R N C,� iia �A. T
Property Address: Road Name
City/ZIP(� .7_...,,i� r _ 2706
If In a Subdivisionprovide information, as follows:
Name: C/JRfZte.rs Couwr- dp
Section: rb 9 Block: Lot: 4e Date Property Flagged: 7 �a
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s)
Issued hereafter are subject to suspension or revocation, If the site plans or intended use change, or if the information
submitted la tris application is falsified ar cb"r red. 1, also, understand that I wx respow151'e jce cll charges Incufred from
this application. I, hereby, give consent to the Authorized Representative of the Davie County Health Department
to enter upon above described property located In Davie County and owned by
to conduct all testing procedures as necessary to determine the site suitability. /
DATE,A�j SIGNATURE Lfil� /i
all of the following: Existing and proposed
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN
property lines and dimensions, structures, setbacks, and septic lora
Revised DCHD (07/99)
Site Revisit Charge
Client Notification Date:
EHS:
Account No.
Invoice No. — 602
***XMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED
INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions.
1.
11
name to be Billed
Contact Person
�
tailing Address '/ �!/� L,� „-ftp �%
Some Phone
City/state/SIP �l,.f'-cra�:�tL f �. L
i d d 6 Business Phone
2.
Mame•en Perait/ATC if Different than Above
Mailing Address
City/state/Zip
3.
Application For: 0 Site Evaluation
0 Improvement Permit/ATC �oth
4.
system to service: (\House 0 Mobile Home 0 Business 0 Industry 0 Other
S.
If Residence: # People
# Bedrooms _3 # Bathrooms Z
O Dishwasher ❑ Garbage Disposal 0 washing
Machine O fts a t/Plumbing ❑ Buement/No Plumbing
6.
IfBusiness/Industry/other: Specify type
# People # Sinks
# Commodes # Showers
# urinals # water Coolers
IF FOODSERVICE: # Seats Estimated Stater Usage (gallons per day)
7. Type of water supply: 0 County/City 0 Well 0 Community
a. foo you anticipate additions or expansions of the facWty this system is intended to serve? 0 Yes D No
If yes, what type?
***IMPORTANT*** CLIENTS MUST COMPLETETHE REQUIRED PROPERTY INFORMATION REQUESTED
BELOW. Either a PLAT or SITE PLAN MUST BE SVBA977FO by the client with THIS APPLICATION.
7Ar svor,Z o
Property Dimensions: G� WRITE DIRECTIONS (from Mocleville) to PROPERTY:
Tax Office PIN: # 5? 7 5�- 0 6 7, o y�/R N C,� iia �A. T
Property Address: Road Name
City/ZIP(� .7_...,,i� r _ 2706
If In a Subdivisionprovide information, as follows:
Name: C/JRfZte.rs Couwr- dp
Section: rb 9 Block: Lot: 4e Date Property Flagged: 7 �a
This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s)
Issued hereafter are subject to suspension or revocation, If the site plans or intended use change, or if the information
submitted la tris application is falsified ar cb"r red. 1, also, understand that I wx respow151'e jce cll charges Incufred from
this application. I, hereby, give consent to the Authorized Representative of the Davie County Health Department
to enter upon above described property located In Davie County and owned by
to conduct all testing procedures as necessary to determine the site suitability. /
DATE,A�j SIGNATURE Lfil� /i
all of the following: Existing and proposed
THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN
property lines and dimensions, structures, setbacks, and septic lora
Revised DCHD (07/99)
Site Revisit Charge
Client Notification Date:
EHS:
Account No.
Invoice No. — 602
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DAVIE COUNTY HEALTH DEPARTMENT
Environmental Health Section
SoiVSite Evaluation
APPLICANT INFORMATION
PROPERTY INFORMATION
Account #:.:.989900562
,.
Tax PIN/EH #:
5778-06-7187.04
Billed To:
Gray CarterSubdivision
Info:
Carters Court Lot # 4
Reference Name:
Gray Carter
Location/Address:
Williams Road -270W /
Proposed Facility:
Residence
Property Size: 370x300x250. Date Evaluated: owl'
Water Supply:
On -Site Well
Community
Public
Evaluation By:
Auger Boring
Pit
Cut
FACTORS
1 . .' - 2. 3 . - 4
'5 6 7
Landscape position .....
L I,—
Slope %
HORIZON I DEPTH
Tnrnxr omen
-
-
Consistence I L -1
Structure
Mineralogy
HORIZON II DEPTH �� •�
Texture group"
Consistence .
Structure C'
Mineralogy
HORIZON III DEPTH '
Texture group
Consistence
Structure'
Mineralogy
HORIZON IV DEPTH. ,
Texture group
Consistence
Structure
Mineralogy
SOIL WETNESS
RESTRICTIVE HORIZON..^ .
SAPROLITE'
CLASSIFICATION
LONG-TERM ACCEPTANCE RATE c
SITE CLASSIFICATION. Ove �� C EVALUATION BY:
LONG-TERM ACCEPTANCE . :
RAA TE: , y A � OTHER(S) PRESENT: ;
REMARKS: 6�,1J j1 !G �� �i ✓ .
LEGEND
Landscape Position
R - Ridge. -- S - Shoulder L - Linearslope FS - Foot slope N -Nose slope
CC - Concave slope ' 4 CV - Convex slope T - TerraceFP - Flood plain H.- Head slope
Texture
i
S - Sand, LS - Loamy sand :. SL - Sandy loam .. L -Loam SI'- Silt
SICL - Silty clay loam SIL - Silty loam CL -Clay loam SCL -Sandy clay loam
y y Silty clay COONSI
SC Sand clay SIC STENCE
i
VFR - Very friable FR - Friable FI - Firm VFI - Veryfirm EFI - Extremely firm;
Wet` '
NS - Non sticky SS Slightly sticky S'; Sticky VS Very Sticky
NP - Non plastic SP - Slightly plastic P - Plastic VP,- Very plastic
Structure
SC Single grain M - Massive CR - Crumb GR - Granular, ABK - Angular blocky
SBK - Subangular blocky PL - Platy PR - Prismatic
Mineralogy .
1:1, 2:1, Mixed
Notes
Horizon depth In inches
Depth of fill - In inches
Restrictive horizon Thickness and inches from land surface
Saprolite - S(suitable), U(unsuitable)
Soil wetness - Inches from land surface to free water or inches from land surface to soil colors with chroma 2 or less
Classification - S(suitable), PS(provisionally suitable), U(unsuitable)
LTAR - Long-term acceptance rate,- gal/day/ft2
DCHD 05/99 (Revised)